CIGNA Corporation

Review: I underwent a bone graft surgery procedure on 4.3.14. I Am insured with Cigna through my employer [redacted]. While home health care post op services were necessary, prescribed by my doctor and is a covered service by my plan with Cigna, they refused to provide and failed to. I fell 5 times since my surgery living home alone with no help. They also denied me an MRI, much needed for a spine treatment and diagnosis two months ago. Last year I walked on a fracture for six weeks before the MRI was approved by Cigna which detected the fracture. That last week I had bone graft done on it because I didn't get treatment on it in time. Also last year, while I have AVN and a fracture the doctor prescribed orthotics. After Cigna sent me to one of their vendors, they denied the claim. I have AVN in both feet, a fracture that didn't heal because you denied me MRI to diagnose it and you denied the orthotics because you claim my medical documents only stated I had seasmosids.

Product_Or_Service: naDesired Settlement: Desired Settlement: Other (requires explanation)

You will approve the cervical spine MRI. You will reimburse me for the PCA I hired out of pocket to help me with bathing, transport and dressing daily since the day of surgery. You will pay for the orthotics, I already paid my cut. Any more neglectful decision and I will forward all the above info to the attorney general for your neglect and terrible service.

Business

Response:

We have sent a written response to the customer in regard to Revdex.com Complaint # [redacted].

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

I got the letter todayI will have you know, my Dr ordered a visiting nurse along with a home health aid to help !e with wound care, bathing, dressing and transport

Review: I have had Cigna health insurance for a year now, my insurance card states that the company covers 80% of fees and I will pay 20% of fees for in-network doctor visits. About 3 weeks ago I decided to go to the doctor to get some lab work done. I called Cigna to find an in-network doctor in my area and then scheduled an appointment. After everything was said and done I received a bill from the doctor for $618.32 and figured I had to forward this information to Cigna for them to cover the 80%. After calling I was told that Cigna will not cover these charges because my deductible had not yet reached $1250, I was at over $500. When I originally called Cigna to schedule an appointment nobody explained to me that I was going to pay full price for everything, and when I originally signed up for Cigna nobody explained to me that I had have to have the service for 2 years before I would even be covered by the company. I would have been better off saving the money I was paying towards insurance and applied it towards this bill. I asked the lady on the phone if I could apply the money I have paid toward the deductible towards my bill and she kept saying she didn't understand what I was asking so I told her to have a nice day and we hung up. I have decided to cancel my service which will take effect next month and if this is the way insurance works with Cigna I really don't see myself going back.Desired Settlement: My desired outcome would be that Cigna cover the 80% as stated on my health insurance card, it would have also been very helpful if they would have explained to me that I was liable for all charged when I first called them to schedule an appointment with an in-network doctor in my area.

Business

Response:

Hello [redacted],

Review: NO BENEFITS

This is regarding my son's insurance. His name is [redacted]. His member ID is: [redacted] His plan was changed to a new plan effective January 1st, 2014. However, we did not receive any ID card until today (Jan 27). Therefore, we cannot buy any medicine for him this month.

I called customer services many times regarding this matter, but nothing was done. Some representatives said that they could not see the new plan on the system, some said they saw it and would send the card by mail, but nothing arrived (only useless junk letters from Cigna I kept receiving). Today, I called FIVE times, and no help was given. One representative just hung up in the middle of the conversation.

In conclusion, WE COULD NOT BUY ANY MEDICINE IN JANUARY 2014 BECAUSE OF YOUR LACK OF RESPONSIBILITY. YOU DID NOT SEND OUR NEW ID CARD, AND YOU COULD NOT HELP ME GETTING ONE. I WILL STRONGLY SUGGEST EVERYONE I KNOW TO STAY AWAY FROM CIGNA.Desired Settlement: Refund for January 2014's premium.

Business

Response:

Thank you for this inquiry. I will review and respond directly to the customer.

Thank you,

Review: I worked for [redacted] and had this Insurance as part of my benefits.My husband and children were covered on this plan, and so after Perscription Drugs are paid for out-of-pocket, the Reimbursement program is to send in receipts and fill out forms with all the pertinent information.We did that after Perscriptions from Sept.1-April 30 were filled and paid for by us.I sent them snail-mail to their Corporate office in Arizona and called to make sure that is where we sent them, according to the official paperwork given me by [redacted] and their Benefits Dept. Cigna LOST the paperwork, or it never arrived (U.S. Postal Service? Can it be that bad?). I waited a couple of months with no contact from CIGNA. I called back, and found out they had NOT received all my paperwork. CIGNA would not permit the copies I had photographed of the documents to be sent in via fax or email, so I resent it in hard copies again.Over the next 6 months, we have not received any payments! We called many times, spoke with several Supervisors, and did everything we were asked to, including faxing documents in, and proofs that we had sent them.Just today, we were told that a Pharmacists signature was required, and the resubmission process was rejected in Nov. 2013. This is after 3 months of waiting for our payment of reimbursement! We were promised that the Supervisor would call [redacted] and take care of the problem, or let us know how to make sure the payment went through this time. It seems that no one follows up, or that CIGNA purposely prevents paying out their claims. We are disappointed and we have lost a great deal of time trying to recover what is rightfully ours by contracted benefits.Thank you.[redacted]###-###-####

Product_Or_Service: CIGNA Healthcare Benefits through [redacted] Inc.

Order_Number: Policy Number of Hea

Account_Number:[redacted]Desired Settlement: DesiredSettlementID: Other (requires explanation)

I would like Cigna to send us the Reimbursement amount of $394 plus $200 extra for all the lost work time that my husband Michael and I have spent trying to rectify this situation. We have jumped through Cigna's hoops with their "PayFlex" program, to to avail. We get the run-around instead, and it costs us precious work-time and money.Total asked Reimbursement: $594.

Business

Response:

We are reaching out to the customer today regarding this issue.

Thank you,

Review: I never enrolled with CIGNA Medicare Rx. I never asked to be enrolled with CIGNA Medicare Rx. I never authorized myself to be enrolled with CIGNA Medicare Rx. I never used CIGNA Medicare Rx or any benefit therefrom. CIGNA Medicare Rx is billing me for a "prior invoice balance" for an enrollment that I never authorized or was aware of.Desired Settlement: I want CIGNA Medicare Rx to remove me from their records, stop sending me bills, adjust the account that bears my name to $0.00 and to NEVER, UNDER ANY CIRCUMSTANCES, CONTACT ME AGAIN.

Review: Applied for health insurance 9/24/13, denied 9/25/13. Received email 10/3/2013 requesting I apply for health insurance.

I find it very distasteful to deny someone health insurance and then still send out advertisements enticing someone to apply. It's disrespectful and humiliating considering the reasons in which I was denied. It shows there is no class or care in this companies policies.Desired Settlement: I wish for nothing from Cigna. I only request they reconsider their practices. I would contact them directly but I feel this will be the only way to get the point across.

Business

Response:

Please note that a letter was sent to the customer on 10/23/2013 addressing his concerns. Thank you.

Review: To Whom it May Concern:

We have made numerous attempts to collect payment on the enclosed [redacted]'s for services rendered to patient A Patient date of service 02/16/13 and 02/26/13.

These claims have been sent to you numerous times. We have received different answers each time we have contacted you.

After submitting these claims 5 or more times, we are officially filing a complaint with your company.

1. Our claims were being processed as "out of network" when we were "in network." We would have to call and get them re-processed.

2. Our payments and EOB's were being sent to the wrong address - even after numerous calls to you and confirming numerous times that you did have our mailing address.

3. We were told several times that the patient (A Patient) we called to pre-authorize had met her deductible because of 4th Quarter Carry-Over. Yet when the claim was processed - a deductible was withheld.

4. We have been given numerous explanations as to why we haven't received payment yet, but payment never has been made.

Summary of Phone Calls from February 2013-July 2013

Feb 2013- Called to pre-authorize [redacted]. We were told twice that her deductible was met "due to 4th quarter carry-over." We submitted the [redacted] and Cigna responded by paying "Out-of Network" instead of "In-Network" - so we had to have them correct that. Cigna had also sent the payment to the wrong address- we went through the steps in order to have them update to the correct address - and they assured us that they had the correct mailing address in their system.

March 2013- On March 7th, 2013, they paid "In Network" and the payment was $223.34- but once again, they sent the payment to the wrong address and it was never received. They informed us they would put a stop payment on the check and re-issue. At the end of March, I phoned again; this time asking for a supervisor. I spoke to [redacted]. She said the correct address was in their system now and she would have the check re-issued.

April 2013- Called Cigna and once again they said it was sent to the wrong address. They suggested this time we call [redacted]) and get it updated with them. I phoned [redacted] and they said they would make sure Cigna gets it right. Meanwhile, [redacted] at Cigna, said she would put a stop-payment on the check and re-issue. She said it may take 30 days. Ref#[redacted]. She looked and said that once again, the address in the system wasn't the correct one. On April 24th, I spoke to [redacted] to see what progress was being made. She said a stop-payment was put on the check, but they forgot to reissue the check. [redacted] said we should receive the check within 10-15 days. We never did.

May 2013- On May 14th, I spoke with [redacted] - a supervisor. Ref# [redacted]. He looked in the notes and said the supervisor "[redacted]" was "over ruled" and that they had applied the payment to the patient's deductible instead. She said she would look into it.

June 2013- June 25th- called and they still had the old address in the system. They suggested we call "Provider Solutions" and they would straighten it out. We called them and they assured us it would be taken care of.

July 2013- Called again July 9th- said that the check in the amount of $223.34 was re-issued - however they had everything correct but the zip code and check was never received. They said they would put a stop-payment and re-send. On July 22nd, I called and spoke to another supervisor-[redacted] Ref#[redacted]. He said the check would be re-issued within 10 business days. I called on July 23rd and [redacted] said within 48 hours check would be re-issued. I called again July 29th; spoke with [redacted]. I explained the situation to him and was told that the amount again was applied to the patient's deductible.

Once again, we are sending the claim over to you. We have attempted to work with you on this matter, with no results, so we are sending copies of this letter (with patient's name deleted for HIPAA laws) to American Medical Association and Revdex.com to help us resolve this matter.Thank you for your immediate attention to this overdue matter and we would appreciate a response.

Sincerely,Desired Settlement: Unspecified

Consumer

Response:

Please see attached complaint

Business

Response:

Hello,

I have made contact with the biller and am currently researching her concerns. Upon resolution, I will outreach the complainant directly.

Thank you,

Review: company never answers phone,,,takes for ever to talk to aclaims person and most times all you get is there answering machine..they request me to get info and when I do I am told that they should make the request, terrible customer supportDesired Settlement: I would like them to start by letting you speak to some one instead of getting answering machines

Business

Response:

Dear **. [redacted],

Please find my response to your letter regarding [redacted]. Dept. File Nr [redacted]

Thank you,

Consumer Advocacy Specialist

Review: In April I took a insurance policy with Cigna. I have called every month to give them my payment since they do not do online payments.

On June 15, 2013 they sent me a termination letter as of 5-31-13. After I called they are constantly asking me to send them my bank statements showing this which I have faxed. Payment was made in April and May. Two more payments made on 6-19-13 and 6-26-13 which have been

deducted out of my bank account. Cigna has never credited my policy with these two payments. If they are terminating my policy 5-

31-13, they owe me my two premiums back of $322.00 each.

[redacted]Desired Settlement: Cigna received two premiums of $322.00 each after their termination letter.

This has been a constant problem with them.

Thank you

Business

Response:

Please be advised that a final request was sent to **. [redacted] on 7/19/2013. Customer did not return the release of information, therefore the final response was sent directly to the customer.

Thank you.

Review: Cigna performed an unauthorized debit of my primary checking account. They are refusing to refund the money even though this left account overdrawn.

I, [redacted], attempted to pay a past due balance to Cigna online using my credit card account. Instead of informing me that credit cards are no longer authorized for making account payments(I was NEVER informed of this prior), the website completed the transaction using my bank account WITHOUT my permission. This unauthorized debit has put my account balance in the negative. I'm incurring NSF fees now for everyday until I get paid. This debit occurred on 8/25/2014, for the amount of $265.31 and the confirmation number for the transaction is [redacted].The case number is [redacted]. When I contacted them about this, they refused to refund me and only gave an apathetic/rude apology.Desired Settlement: I want a refund for the original $265.31 that was wrongfully debited, and the $35.99 for the NSF fees my bank is charging me. I would rather not seek legal action, but I will, if forced to do so.

Business

Response:

Hello-This complaint has been addressed directly with the customer.Thank you Tanya H[redacted]

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because: When was the issue of money being taken from my account without my authorization ever resolved? My account was in the negative because that mistake and I was never returned what I am owed. If the rolls were reversed and I owed your company money, you people would've sent my account to a collection agency by now. An incompetent firm with apathetic, insincere employees screws me over, and all I'm offered is a mediocre apology with no assurance of repayment. The issue was "addressed," but not RESOLVED.

Regards,

Business

Response:

Hello-Thank you for sharing this customer's concerns. A formal follow-up has been mailed to the customer in response to this. Thank youTanya H[redacted]

Review: Cigna offered insurance for $423/month.

I applied "on-line" and part of that application required my [redacted] card information.

The application could not be submitted without the [redacted] card information.

On March 20 (by email) Cigna offered me insurance but raised the rate to $635/month.

On March 20, (responding to Cigna's email ) I rejected Cigna's offer.

On March 21, Cigna charged my [redacted] card $670.

Cigna refuses to credit my [redacted] card and admit that it was NOT authorized to charge my card, after I rejected their offer.Desired Settlement: This charge has been challenged to [redacted].

I will not accept a check, because then I will have to pay interest on the unauthorized charge, that has not been paid.

Cigna must admit that it did a rate "bait and switch" on this insurance offer.

Cigna must credit the $670 back to our account.

Business

Response:

Good day,

Written communication that includes resolution has been sent to the customer.

Thank-you.

Review: I have Cigna through my emmployer. This new benefit year they have made decision for drugs are a required such as inhalers there would be a cost (2012 they were free). I use Proair and Advair in which there are no generic for the because the drug makers have not made any. For my Advair, there are not inhalers that are equal nor are they any generic. They are requiring their customers to not only for the medication that is required to maintain my life but also since there is no generic I have to pay for the price of the brand drug. So because there is no generic, as a customer I am getting penalized to pay at a high cost that I can barely afford. And before they say it was my employer's decision to have such drugs like reimbursed at this rate, they are not being truthful because my employer can tell the insurance company to charge us for drugs like this.Desired Settlement: To go back to their drug list where drugs that are necessary to be free like last year or pay a much lower rate. I cannot choose to not take my medication because they are a requirement for me to live and breathe.

Business

Response:

Our final response to [redacted] has been (4/24/13) sent via mail. Customer did not give permission to advise the Revdex.com of the final outcome. Customer may advise the Revdex.com upon receipt of our decision.

Thank you.

Review: I have insurance with Cigna and have contacted them 3 times in the past 90 days to resolve an issue where they failed to pay for a service provided by CMC for my wife Karen on 5-7-14, my plan states that she will receive 3 dietician free each year, our plan has not changed but Cigna has only paid a potion this year and has been given me the run around since June.

She received the 3 visits last year at no cost and our plan has not changed.Desired Settlement: I expect Cigna to pay CMC Union the amount of $212.68 the remaining portion of the amount that is due.

Business

Response:

Revdex.com Complaint # [redacted] has been resolved. A message was left for the customer today.

Review: My insurance coverage with CIGNA started on 11-15-2010 and ended 01-27-2011. My son was seen by his pediatrician on 11/2010 claim was submitted by doctor on 11-22-2010 and 01-03-2010, he was also seen on 12-21-2010 claim was submitted by doctor on 12-23-2010, 01-21-2011 claim was submitted by doctor on 01-24-2011. As you can see my son was seen under the coverage period and was filed by my doctors office in a timely manner. Cigna has been claiming that they do not need to pay the bills because the date of services and sent claims does not fall under the coverage period, which it clearly does. My doctors office as well as myself have been fighting back and forth for over two years without resolution. I have been told by CIGNA on numerous occasions that it would be solved, but with no avail. I am also forwarding this comaplaint to the Revdex.com and Federal Insurance Commisssion.Because of this my son has had to go to other doctors and it has negatively affected my credit score as well as I have been sent to collections.Desired Settlement: for them to pay the collection agency directly

Business

Response:

Good day,

The customer's account has been reviewed and the impacted claims have been corrected according to recent information received from the healthcare provider's office. Written correspondence regarding the outcome has been sent to the customer.

Review: Cigna withdrew money out of my account and then charged me a NSF fee.

The account number for my Cigna insurance is [redacted]. On 5/22/14 Cigna cleared an ACH debit for $48.43 from my checking account and then turned around and stated on mycigna.com that I had NSF from savings. The account is set up for checking and credit card. [redacted] faxed them a copy of my bank statement showing that the money cleared my account and was never returned for NSF. I have been calling them since 06/01/14 and as of today's date still has not been corrected. I just received a letter stating that my coverage will cancelled as of 6/30/14 due to their error. They also trying to get me to pay a NSF fee of 45.00 that is incorrectly applied.Desired Settlement: I want the NSF of 45.00 reversed immediately and an apology for my time of trying to get this corrected.

Business

Response:

Cigna has completed our review of this Revdex.com

request and a final resolution has been sent to the customer today, June 27, 2014.

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because: I have not received anything from cigna and my account on mycigna.com is showing I owe 90.00 which is incorrect. I have faxed them all the documents to prove that their accounting has been incorrect but it seems like they are still just trying to get additional money from me

Regards,

Review: I authorized payment for 3/31/14 & they deducted then and 4/1/14 as well I requested them to correct this on 4/2/14 told it would be done in 7-10 day

Today is the 11 day and have spoken with as stated 4/2 & 4/7 both times told done but done until I spoke with a Supervisor named [redacted] was it done but now stating will take 7-10 days from then and now today told 7-10 days to process then another 7-19 days to get funds back, We are nseniors on limited income and this double dip fromn our account caused is to be overdrawn and to date 280.00 in OD chargesnwhich my bank says will return to us once Cigna refunds the monies, Has also caused late fees on other debts and no matter how I appeal or request they do not care that we are suffering for their mistake as want to claim its our fault that we requested auto draft which I never have and no way they can prove it or show signature requesting that,Desired Settlement: the extra payment of 554.49 they have overcharged us this month.

Business

Response:

The customer was contacted via phone call on May 1, 2014 and the customer confirmed resolution.

Review: My husband and I went to a dentist [redacted] on 10/4/12 to get an extraction. A dental office staff had several conversations with CIGNA reps to check his coverage and CIGNA reps kept telling us that the service would be covered based on his remaining benefits for 2012. However 10 days later, we found out that the claim didn't get paid because the dentist was out of network. During these several calls with CIGNA reps on 10/4/12, NO ONE checked and informed us that we were in the "core" network, but the dentist was in the "radius" network. None of them mentioned that [redacted] would be considered out-of-network and that none of the service would be covered.

Customer representatives failed to inform us the most crucial information of coverage and failed to fulfill our patients' rights to receive the understandable information you need about your health benefit plan, including information about services that are covered and not covered and any costs that you will be responsible for paying, which resulted in the unpaid claim ($257.20) due to the out-of-network calendar maximum. Not only did we not have a chance to look for an in-network dentist prior to receiving the service, because we had not been provided with the correct coverage information, but also there was no accountability taken for the errors and the wrong information provided by the CIGNA reps.Desired Settlement: We would like to be considered the service on 10/4/12 as in-network service and would like to be reimbursed for the amount we had to pay out of pocket. We request a reimbursement for $257.20.

Business

Response:

-----Original Message-----

From: [redacted]

Sent: Tuesday, April 09, 2013 9:32 AM

To: [redacted]

Subject: [redacted]

Our fax is [redacted]

--- Original Message ---

Allison, this case#[redacted] is no longer on the Revdex.com website. Additionally, the customer was notified on 4/2 of our decision.

Consumer

Response:

RE:

Acceptance of CIGNA's response

RevDex.com:

I have reviewed the response made by CIGNA in reference to complaint ID

[redacted], and find that this resolution is satisfactory to me.

Review: I am the primary insurance holder for our insurance policy with Cigna. My wife gave birth to our little on 6-20-13. As you well know, when there is a birth there a few different claims that are filed. It is not one big package. All of our claims were handled appropriately except for one. This one involved the anesthesia during my wife's labor. The claim number is [redacted]. Our insurance is with Cigna.

Let me explain briefly. In October of 2012 I was told that Cigna was not going to pay anything on this claim. I was then told a few weeks later that Cigna was going to pay something on this claim. By the end of December 2012 no payment had been made and I really needed to know if anything was going to be paid because we had money in our Flexible Spending Account. I called Cigna approximately 3 times at the end of December. I called once and the agent said Cigna is not going to pay anything toward this claim. I called again the next day and a 2nd agent said that she could not understand why Cigna was not going to pay and she said that she would have it reviewed.

At this point I am talking to my insurance person at work and she says that she thought our plan paid out claims using the "supplemental" method, not the "non-duplication" method. I bring this up with Cigna agents and most of them don't know what I am talking about or say that claims are paid out on a "non-duplication" basis.

I called a 3rd time and I was told the review had been completed and Cigna would not pay anything toward the claim. I called a 4th time and I was told that Cigna would not pay anything toward the claim. Even though my insurance person says normally claims have been paid out using the "supplemental" method at this point I assume that I am being told the right thing since I have spoken to numerous agents and they are basically telling me the same thing - WE ARE NOT GOING TO PAY OUT ANYTHING ON THIS CLAIM. Because of this we leave some money in our flexible spending account to cover the expense of this claim.

CAN YOU IMAGINE MY SHOCK when I receive a letter from Cigna in early January saying that they are going to pay out on this claim. I thought it was a joke. It was hilarious. Nevermind the fact that this claim had been filed in early October and they had 3 months to get it taken care of. I mean was this really happening. After speaking to agent after agent and being told - NO, WE ARE NOT PAYING OUT ON THIS CLAIM, Cigna decided to pay out on this claim.

I call Cigna back after receiving this letter and tell them what has happened. One agent looks back through the call records and says "Yes, **. [redacted] you are correct. I see where we told you numerous times that we are going to pay out on this claim." She tells me that she will have it looked into to. Somebody does look into it and I am basically told that nothing can be done. I tell them but your company told me numerous times that you would not pay out on this claim. Because of this we left money in our FSA to pay the claim. Because of what you told me one million times, I believe you.

Cigna basically said they did not care. That there was nothing they could do.

Cigna gave me misinformation and it cost me money. Worst of all, they said they don't care. They said - Yes, we see that we made a mistake but there is nothing we can do about it.

I have now wasted hours of my life trying to right this wrong. I have lost money because of the misinformation I was given over and over and over again.

Thanks for your time.Desired Settlement: I need to be compensated in some way. I have lost hours of my life pursuing this and I have lost actual cash money because of this.

It would have been one thing if I only called in once at the end of December but I called in 3-4 times and was told over and over - No, we are not giving you any money for this claim.

This misinformation has cost me money and time. I would like to be compensated for both.

It is the insurance companies job to know what is going on and I knew what was going on better than they did and I am a Special Education Teacher.

Thanks for your time.

Business

Response:

Cigna has completed our review of this Revdex.com request and a final resolution was sent to the customer today, January 3, 2013.

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

Review: I've filed a medical claim with CIGNA for a 2-day medical evaluation service that I had received at [redacted] Medical Center on 4/29-4/30 2013. The claim was filed on 5/31/2013.

I've filed a medical claim with CIGNA for a 2-day medical evaluation service that I had received at [redacted] Medical Center on 4/29-4/30 2013. The claim was filed on 5/31/2013 and the total amount was $5,100. It was divided into 2 CPT codes: One for $3,700 and the other one for $1,400.

Since then, I’ve called CIGNA 5 times regarding this matter.

First issue: They’ve processed the claim wrong. There were 2 claims on the website: One for $51 for a doctor called “[redacted]” which I’m not sure how they came up with as such a doctor doesn’t exist. Second one was for a doctor called “[redacted]” which was the correct one for $5,100. Somehow, they processed $51 right away but needed additional information (breakdown of CPT codes) for the $5,100. I called to tell them to fix this mistake. I’ve also told them all the forms were sent together, including the one that had the breakdown of CPT codes folded together in each other and how come they’ve lost one? So they made up a doctor name and lost a form. I’ve resent the form and it took them over 3 weeks to fix the doctor’s name and correct the amount. To this date, there’s still a claim “pending for action” for [redacted] which too tired to deal with.

Second issue: After they reviewed the corrected claims, CIGNA decided that the maximum covered amount for the $3,700 was only $1,200 and they processed the claim. The other claim (for $1,400) was processed at the same time and didn’t have a maximum covered amount. I decided to appeal for the $3,700 claim as I didn’t have any other place to go to get the treatment. For the $1,400, they decided to “re-examine” my claim without any notification and explanation. My last call was on 7/31/2013 and I asked for a written explanation for the reason why my claim was being re-examined and why it was taking so long. I never received anything.

Third issue: I’ve called CIGNA throughout this ordeal 5 times and they took my phone number twice and I requested them to call me back. I haven’t received a single call back.

Fourth issue: While some representatives on the phone tried to help, the others were rude and less than understanding of my situation and didn’t care a bit to help me out.Desired Settlement: I want CIGNA to get back to me in writing and by phone to explain me why my claim was so ridiciously delayed without any explanations even if I tried to call and understand. Their attitude to customer is unacceptable especially in the health care industry that they're in. I was and I am sick and all I'm trying to do is to get better. I don't go to the doctor so I can charge CIGNA extra. They're there for a reason but they're doing their best to make me get tired of it so I give up and they never make any payments back to me. I have a higher education and a full time time. Not only they've been wasting my time, but they've been very unrespectful to me by not even giving me a single explanation for the events that have happened.

Shame on CIGNA and their system.

Business

Response:

Thank you for bringing this to Cigna's attention. I have contacted the customer and am currently researching this issue. Upon resolution, I will contact the customer and advise of my findings.

Thank you,

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because:

My issue has not been resolved. Since the complaint, I've talked to a manager and she's been helpful. However, she even doesn't know why they're re-examining my claim. She also admitted that they went over their designated time (21 business days) for re-reviewing my claim.

Finally, I just saw online that the status of the claim changed to "not paid" and as the reason, they mention, they already processed this claim. Yes, they did and then they decided to pull it back and re-examine it. This is like a joke so the response is acceptable as my issue is not resolved.

Regards,

Business

Response:

Hello,

Cigna has reached a resolution on this matter. As requested in the original complaint, I have attempted to contact [redacted] twice at ###-###-####. Both times, I have left voicemails and requested a callback. I will attempt to call the customer on Tuesday, September 3, 2013.

Thank you,

Review: I have not been paid for a valid insurance claim. The claim was submitted as a single claim on March 13th. One part of the claim was paid as of a week ago. The other part of the claim hasn't been paid. I've been told on multiple occasions that both claims would be paid within a certain number of days. It has not happened and there is nothing being done about it. The turnaround time for a claim is supposed to be 30 days or less. The claim was initially completely rejected for no reason. When I pointed this out, there was a 15 day delay in determining another issue with the claim, but I was told it was still reimbursable as of an email on May 1st. And a bunch of other issues have happened and no one is willing to help me.Desired Settlement: 1. An immediate payment of the claim. 2. Assignment of a competent claims handler for remaining open claims that are having similar problems. 3. The correct and on-time payment of all remaining claims.

Business

Response:

Cigna has received this complaint and has made appropriate outreach to the customer in order to gain additional information. Once clarifying details are received, Cigna will investigate and then work with the customer in order to facilitate resolution.

Thank you,